黄雄杰 贾春华 辛小红 张宇

摘要 中醫逆其证而治的特点决定了治法往往是相反成对的，基于治法而言的药性也可以相反而分的。现将相反药性配伍由“相反相成法”更名为“相反药性并用法”，论述了此法的内涵及6种代表形式：补泻并用、寒热并用、升降并用、散收并用、动静并用、燥润并用。分析经方、时方及古今医案发现，除药味数极少的方剂外，“相反药性并用法”是普遍存在的，相反药性药物的药效并不互相抵消，而是互相制约，并行不悖，各奏其效，方剂中体现此法的形式越多，临证中运用的范围越广，且此法涵盖12种基本治法而尤显重要。因此，临证中应当主动运用此规律审查处方配伍，一般而言，至少需要兼顾6种形式之一而避免单一药性组方，且需根据病证协调相反药性在处方中的整体用药比例。

关键词 相反药性并用法;相反相成;补泻并用;寒热并用;升降并用;散收并用;动静并用;燥润并用

Exploration of “Joint Application of Opposite Traditional Chinese Medicine”

HUANG Xiongjie1，2，JIA Chunhua1，XIN Xiaohong2，ZHANG Yu1

（1 School of Traditional Chinese Medicine，Beijing University of Chinese Medicine，Beijing 100029，China; 2 Xinjiang Medical University，Urumqi 830054，China）

Abstract The characteristics of traditional Chinese medicine （TCM） treatment against its syndromes determine that the treatment methods are often opposite in pairs，and the medicinal properties based on the treatment methods can also be divided in opposite directions.In this paper，the compatibility of opposite medicinal properties is changed from “opposite and mutually forming method” to “joint application of opposite TCM”，and the connotation of this methods and 6 representative forms are discussed：using tonification and drainage simultaneously，using cold and heat therapy simultaneously，using raising and descending simultaneously，using dispersing and contracting simultaneously，using moving and static simultaneously，using drying and moisturizing simultaneously.The author analyzes prescriptions of Treatise on Febrile and Miscellaneous Diseases，prescriptions of ancient China，ancient and modern medical records，and believes that except for prescriptions with very few species of medicine，“joint application of opposite TCM” is ubiquitous.The effect of opposite medicine is not offset by each other，but rather mutual restriction，running parallel，each plays its own effect.The more forms of this method are included in prescription，the wider the scope of clinical application is.It is especially important because this method covers 12 basic treatment rules.Therefore，we should take the initiative to use this rule to review prescription compatibility in clinical practice.Generally speaking，one of the 6 forms should be considered to avoid using the prescription of single property of a medicine at least.It is necessary to coordinate the overall proportion of the opposite medicines in the prescription according to the disease and syndrome.

Keywords Joint application of opposite traditional Chinese medicine; Opposite and mutually forming method; Tonification and drainage; Using cold and heat therapy simultaneously; Raising and descending; Dispersing and contracting; Moving and static; Drying and moisturizing

中图分类号：R289文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.06.017

方剂中药物配伍规律与方法一直是古今学者研究古今名方及医家医案的重点之一，“相反相成法”已被認为是一种常见的方剂配伍规律与方法，张西俭[1]总结已提出的“相反相成法”有：寒热并用、温清并用、水火互济、补泻兼施、消补兼施、散敛合化、敛降并用、敛泄并用、开合相济、润燥共济、刚柔相济、缓急相合、动静结合、行止相伍、走守结合、升降相因、浮沉相合、苦辛合化、表里双解、上下并施、气血兼治、阴阳合施、标本兼顾等23种形式。……